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      Knowledge, Attitude and Practice Regarding Pertussis among a Public University Students in Malaysia

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          Abstract

          Abstract Objective: To study the knowledge, attitude, and practice (KAP) regarding pertussis among students in a public university in Malaysia. Material and Methods: This study was a cross-sectional study using convenience sampling to recruit 171 respondents. The data was collected using a self-administered questionnaire comprised of four different parts: the socio-demographic data, the knowledge, the attitude and the practice towards the prevention of pertussis. The data were analyzed using correlation, independent t-test, and ANOVA according to the different study objectives and types of data. Results: More than half of the respondents (67.8%) indicated that they had heard about pertussis. The school or university (59.6%) was the most common source of information, followed by Internet (46.2%). The most of the respondents (43.9%) possessed moderate knowledge regarding pertussis and knew that Bordetella pertussis is the causative agent of pertussis (76.0%). A significant positive correlation between knowledge regarding pertussis with age (p=0.023) was observed, however, there was no association between age with attitude and practice (p=0.272 and 0.131, respectively). Gender and marital status did not influence the KAP regarding pertussis; nevertheless, significantly different between different faculties. Conclusion: Students from the Faculty of Medicine had the highest knowledge scores, while the students from the Faculty of Nursing had the most top attitude and practice scores compared to students from another faculty. The students from the public university generally had a good level of KAP regarding pertussis.

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          Acellular pertussis vaccines protect against disease but fail to prevent infection and transmission in a nonhuman primate model.

          Pertussis is a highly contagious respiratory illness caused by the bacterial pathogen Bordetella pertussis. Pertussis rates in the United States have been rising and reached a 50-y high of 42,000 cases in 2012. Although pertussis resurgence is not completely understood, we hypothesize that current acellular pertussis (aP) vaccines fail to prevent colonization and transmission. To test our hypothesis, infant baboons were vaccinated at 2, 4, and 6 mo of age with aP or whole-cell pertussis (wP) vaccines and challenged with B. pertussis at 7 mo. Infection was followed by quantifying colonization in nasopharyngeal washes and monitoring leukocytosis and symptoms. Baboons vaccinated with aP were protected from severe pertussis-associated symptoms but not from colonization, did not clear the infection faster than naïve animals, and readily transmitted B. pertussis to unvaccinated contacts. Vaccination with wP induced a more rapid clearance compared with naïve and aP-vaccinated animals. By comparison, previously infected animals were not colonized upon secondary infection. Although all vaccinated and previously infected animals had robust serum antibody responses, we found key differences in T-cell immunity. Previously infected animals and wP-vaccinated animals possess strong B. pertussis-specific T helper 17 (Th17) memory and Th1 memory, whereas aP vaccination induced a Th1/Th2 response instead. The observation that aP, which induces an immune response mismatched to that induced by natural infection, fails to prevent colonization or transmission provides a plausible explanation for the resurgence of pertussis and suggests that optimal control of pertussis will require the development of improved vaccines.
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            Waning protection after fifth dose of acellular pertussis vaccine in children.

            In the United States, children receive five doses of diphtheria, tetanus, and acellular pertussis (DTaP) vaccine before 7 years of age. The duration of protection after five doses of DTaP is unknown. We assessed the risk of pertussis in children in California relative to the time since the fifth dose of DTaP from 2006 to 2011. This period included a large outbreak in 2010. We conducted a case-control study involving members of Kaiser Permanente Northern California who were vaccinated with DTaP at 47 to 84 months of age. We compared children with pertussis confirmed by a positive polymerase-chain-reaction (PCR) assay with two sets of controls: those who were PCR-negative for pertussis and closely matched controls from the general population of health-plan members. We used logistic regression to examine the risk of pertussis in relation to the duration of time since the fifth DTaP dose. Children who received whole-cell pertussis vaccine during infancy or who received any pertussis-containing vaccine after their fifth dose of DTaP were excluded. We compared 277 children, 4 to 12 years of age, who were PCR-positive for pertussis with 3318 PCR-negative controls and 6086 matched controls. PCR-positive children were more likely to have received the fifth DTaP dose earlier than PCR-negative controls (P<0.001) or matched controls (P=0.005). Comparison with PCR-negative controls yielded an odds ratio of 1.42 (95% confidence interval, 1.21 to 1.66), indicating that after the fifth dose of DTaP, the odds of acquiring pertussis increased by an average of 42% per year. Protection against pertussis waned during the 5 years after the fifth dose of DTaP. (Funded by Kaiser Permanente).
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              Immunity to the respiratory pathogen Bordetella pertussis.

              Bordetella pertussis causes whooping cough, a severe respiratory tract infection in infants and children, and also infects adults. Studies in murine models have shown that innate immune mechanisms involving dendritic cells, macrophages, neutrophils, natural killer cells, and antimicrobial peptides help to control the infection, while complete bacterial clearance requires cellular immunity mediated by T-helper type 1 (Th1) and Th17 cells. Whole cell pertussis vaccines (wP) are effective, but reactogenic, and have been replaced in most developed countries by acellular pertussis vaccines (aP). However, the incidence of pertussis is still high in many vaccinated populations; this may reflect sub-optimal, waning, or escape from immunity induced by current aP. Protective immunity generated by wP appears to be mediated largely by Th1 cells, whereas less efficacious alum-adjuvanted aP induce strong antibody Th2 and Th17 responses. New generation aP that induce Th1 rather than Th2 responses are required to improve vaccine efficacy and prevent further spread of B. pertussis.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                pboci
                Pesquisa Brasileira em Odontopediatria e Clínica Integrada
                Pesqui. Bras. Odontopediatria Clín. Integr.
                Associação de Apoio à Pesquisa em Saúde Bucal (João Pessoa, PB, Brazil )
                1519-0501
                1983-4632
                2020
                : 20
                : e4993
                Affiliations
                [2] Pahang orgnameInternational Islamic University Malaysia orgdiv1Kulliyyah of Allied Health Sciences orgdiv2Department of Physical Rehabilitation Sciences Malaysia
                [3] Kuala Lumpur Kuala Lumpur orgnameNational Defence University of Malaysia orgdiv1Faculty of Medicine and Defence Health Malaysia
                [1] Pahang orgnameInternational Islamic University Malaysia orgdiv1Kulliyyah of Allied Health Sciences orgdiv2Department of Biomedical Science Malaysia
                Article
                S1983-46322020000100311 S1983-4632(20)02000000311
                10.1590/pboci.2020.002
                063e6e11-02e7-43ca-9808-8e93ca7ff898

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 28 September 2019
                : 28 May 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 46, Pages: 0
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                SciELO Brazil

                Self URI: Full text available only in PDF format (EN)
                Categories
                Original Article

                Health Knowledge, Attitudes, Practice,Bordetella pertussis,Universities

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